Important note: Information in this article was accurate in 1999. The state of the art may have changed since the publication date.
Predictive value of CD19 measurements for bacterial infections in children infected with human immunodeficiency virus.
Clin Diagn Lab Immunol. 1999 Mar;6(2):247-53. Unique Identifier : AIDSLINE MED/99167673 Betensky RA; Calvelli T; Pahwa S; Department of Biostatistics, Harvard School of Public Health,; Boston, Massachusetts 02115, USA. betensky@hsph.harvard.edu
Abstract:
We investigated the predictive value of CD19 cell percentages (CD19%) for times to bacterial infections, using data from six pediatric AIDS Clinical Trials Group protocols and adjusting for other potentially prognostic variables, such as CD4%, CD8%, immunoglobulin (IgA) level, lymphocyte count, prior infections, prior zidovudine treatment, and age. In addition, we explored the combined effects of CD19% and IgG level in predicting time to infection. We found that a low CD19% is associated with a nonsignificant 1.2-fold increase in hazard of bacterial infection (95% confidence interval: 0.97, 1.49). In contrast, a high IgG level is associated with a nonsignificant 0.87-fold decrease in hazard of infection (95% confidence interval: 0.68, 1.12). CD4% was more prognostic of time to bacterial infection than CD19% or IgG level. Low CD19% and high IgG levels together lead to a significant (P < 0. 01) 0.50-fold decrease in hazard (95% confidence interval: 0.35, 0. 73) relative to low CD19% and low IgG levels. Similarly, in a model involving assay result changes (from baseline to 6 months) as well as baseline values, the effect of CD19% by itself is reversed from its effect in conjunction with IgG. In this model, CD19% that are increasing and high are associated with decreases in hazard of infection (P < 0.01), while increasing CD19% and increasing IgG levels are associated with significant (at the P = 0.01 level) fourfold increases in hazard of infection relative to stable CD19% and decreasing, stable, or increasing IgG levels. Our data suggest that CD19%, in conjunction with IgG level, provides a useful prognostic tool for bacterial infections. It is highly likely that T-helper function impacts on B-cell function; thus, inclusion of CD4% in such analyses may greatly enhance the assessment of risk for bacterial infection.
Keywords: JOURNAL ARTICLE Adolescence Antibodies, Bacterial/BLOOD Antigens, CD19/*BLOOD AIDS-Related Opportunistic Infections/*DIAGNOSIS/IMMUNOLOGY B-Lymphocytes/CYTOLOGY/MICROBIOLOGY/VIROLOGY Bacterial Infections/*DIAGNOSIS/IMMUNOLOGY/*VIROLOGY Child Child, Preschool Female Human IgA/BLOOD IgG/BLOOD Immunophenotyping Infant Infant, Newborn Lymphocyte Count Male Predictive Value of Tests Receptors, IgE/BLOOD Support, U.S. Gov't, P.H.S. Time Factors 990630
A9960962
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Important note: Information in this article was accurate in 1999. The state of the art may have changed since the publication date.
